Provider Demographics
NPI:1235311168
Name:HILL COUNTRY GERIATRIC CARE
Entity type:Organization
Organization Name:HILL COUNTRY GERIATRIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GERIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, GNP-BC
Authorized Official - Phone:512-992-7622
Mailing Address - Street 1:PO BOX 1355
Mailing Address - Street 2:
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642-1355
Mailing Address - Country:US
Mailing Address - Phone:512-548-6088
Mailing Address - Fax:
Practice Address - Street 1:219 CHESTNUT COLT
Practice Address - Street 2:
Practice Address - City:LIBERTY HILL
Practice Address - State:TX
Practice Address - Zip Code:78642-5528
Practice Address - Country:US
Practice Address - Phone:512-992-7622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX613819363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty